Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Reducing growth impairment in infants undergoing intestinal surgery: A quality improvement initiative.","authors":"Julie D Thai, Jessica Liu, Caroline Toney-Noland, Courtney C Breault, Mark V Speziale, Shannon L Burke, Gina M O'Toole, Peggy P Chen, Ching Ching Tay, Jochen Profit, Irfan Ahmad","doi":"10.1002/jpen.2765","DOIUrl":"https://doi.org/10.1002/jpen.2765","url":null,"abstract":"<p><strong>Background: </strong>Infants undergoing intestinal surgery are at risk for impaired growth. Our objective was to reduce growth impairment in these infants by 20% in a 12-month period and sustain over 12 months.</p><p><strong>Methods: </strong>Eight neonatal intensive care units (NICUs) participated in the California Perinatal Quality Care Collaborative-led multisite quality improvement (QI) project, comprising a baseline, active, and sustainability phase. Eligible infants underwent intestinal surgery in the NICU between January 2021 to June 2023. Outcome measure was infants leaving the NICU with a weight z-score decline exceeding (>)1.2 standard deviations from birthweight. Process measures included adherence to parenteral nutrition (PN) guidelines, nutrition rounds, and feeding guidelines. Balancing measures included necrotizing enterocolitis, metabolic acidosis, and feeding intolerance rates. Multisite learning sessions and meetings were held. Each NICU implemented local QI strategies. Measures were analyzed in control charts.</p><p><strong>Results: </strong>581 infants were included. During the active phase, growth impairment remained unchanged at 25%. Adherence to PN guidelines increased from 49% to 68%, nutrition rounds increased from 82% to 91%, and feeding guideline increased from 28% to 68%. In the sustainability phase, growth impairment worsened to 27%. Adherence to nutrition rounds decreased to 82%, PN guidelines increased to 95%, and feeding guidelines sustained at 68%. Balancing measures remained unchanged.</p><p><strong>Conclusion: </strong>Despite no change in growth impairment, multiple centers implemented strategies to optimize nutrition in infants who underwent surgery. Additional data on nutrient delivery, other anthropometrics, and nonnutrition factors should be considered in future studies.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of muscularity status with clinical and physical function outcomes in critically ill patients with COVID-19: A systematic review and meta-analysis.","authors":"Carolyn Tze Ing Loh, Zheng-Yii Lee, Nor'azim Mohd Yunos, Rafidah Atan, Daren K Heyland, Christian Stoppe, M Shahnaz Hasan","doi":"10.1002/jpen.2767","DOIUrl":"https://doi.org/10.1002/jpen.2767","url":null,"abstract":"<p><p>Pre-coronavirus disease 2019 (COVID-19) critical care research underscored the importance of muscularity on patient outcomes. This study investigates the association between skeletal muscle mass and quality with clinical and physical function outcomes in critically ill patients with COVID-19. We systematically searched MEDLINE, EMBASE, and CINAHL from database inception to April 24, 2024, for studies using objective methods to evaluate muscularity in critically ill adults with COVID-19, without language restrictions. Co-primary outcomes were overall mortality and muscle strength. Random-effect meta-analyses were performed in RevMan 5.4.1. We included 20 studies (N = 1818), assessing muscularity via computed tomography (twelve studies), ultrasound (seven studies), and bioelectrical impedance analysis (one study); none had low risk of bias. In analyses of high vs low muscularity, high muscle mass was significantly associated with lower overall mortality (nine studies; risk ratio = 0.74; 95% CI, 0.57-0.98; P = 0.03). When muscularity was analyzed as a continuous variable, COVID-19 survivors had higher skeletal muscle area (SMA) (13 studies; mean difference [MD] = 1.18; 95% CI, 0.03-2.33; P = 0.05) confirmed by sensitivity analysis using standardized MD (0.23, 95% CI 0.05-0.42, P = 0.01) and significantly higher muscle quality (five studies; standardized MD = 0.45; 95% CI, 0.20-0.70; P = 0.0004). Muscle strength findings were inconsistent: one study showed significant correlations between muscle strength with muscle mass parameters (r = 0.365-0.375, P < 0.001) whereas another found no association. In critically ill adults with COVID-19, high muscle mass was associated with lower mortality risk. Survivors had significantly higher SMA and muscle quality. Findings on physical function outcomes remain inconclusive (PROSPERO ID: CRD42022384155).</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current nutrition practices in premature and low-birth-weight newborns: A descriptive cohort study.","authors":"Luciana de Paula, Diana Silva, Cláudia Camila Dias, Rita Moita, Susana Pissarra","doi":"10.1002/jpen.2770","DOIUrl":"https://doi.org/10.1002/jpen.2770","url":null,"abstract":"<p><strong>Background: </strong>This study aims to describe the nutrition approach to preterm and low-birth-weight infants during hospitalization in a level 3 neonatal intensive care unit.</p><p><strong>Methods: </strong>Descriptive cohort study on preterm infants with gestational age ≤34 weeks or birth weight ≤1500 g admitted for hospitalization between January 2021 and December 2022. Data were collected from medical records.</p><p><strong>Results: </strong>The sample consisted of 85 preterm infants. All received parenteral nutrition, which was started on the first day of life in 98.8% of them. Trophic nutrition was started by the third day of life in 74.7% of the preterm infants. The median start of trophic nutrition was 5 days in infants with a birth weight <1000 g, 3 days in infants with a birth weight from 1000 to <1500 g, and 2 days in infants with birth weight ≥1500 g (P < 0.001). Preterm infants with a birth weight ≥1500 g started enteral nutrition and reached full enteral nutrition earlier (P < 0.001) than the other birth weight subgroups. The diet was suspended for >24 h in 26 preterm infants (30.6%). At discharge, 84.7% of the infants were receiving breast milk, with 25.9% exclusively breastfeeding and 58.8% partially breastfeeding.</p><p><strong>Conclusions: </strong>Earlier initiation of enteral feeding in line with the latest guidelines can be optimized with the availability of donor milk from a human milk bank.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of adult patients with intestinal failure-associated liver disease: A descriptive cross-sectional study.","authors":"Shameer J Mehta, Alexandra Zissimopoulos, Konstantinos Fragkos, Sarah Williams, Sarah Faloon, Michael Taylor, Priya Mistry, Vipin Gupta, Martyn Dibb, James Baker, Philip Smith, Philip Allan, Charlotte Rutter, Clare Donnellan, Arun Abraham, Simon Lal","doi":"10.1002/jpen.2769","DOIUrl":"https://doi.org/10.1002/jpen.2769","url":null,"abstract":"<p><strong>Background: </strong>No consensus exists regarding diagnostic tools for adult intestinal failure-associated liver disease (IFALD). This study aimed to determine correlations between histological pathology, noninvasive diagnostic tools, and IFALD severity. Secondary objectives included correlations between noninvasive diagnostic tools in adult patients with a clinical diagnosis of IFALD.</p><p><strong>Methods: </strong>This was a multicenter, cross-sectional retrospective study conducted across six UK IF units. All patients judged to have IFALD were included. Included data were as follows: demographics, IF pathophysiological mechanism, radiological findings, blood results, elastography, and histological findings. Fisher exact tests, Kruskal-Wallis tests, and Spearman correlations were performed.</p><p><strong>Results: </strong>Of 745 patients, 234 patients with IFALD were included (prevalence: 31.4%; median age: 56 years), with 95.3% meeting European Society of Clinical Nutrition and Metabolism criteria. Three fibrosis scores were used in 51 liver biopsies (Brunt et al.: 5 [9.8%]; Ishak et al.: 10 [19.6%]; and Metavir et al.: 10 [19.6%]). Elastography was performed in 57 patients (24.4%), with a median stiffness of 7.35 kPa. Histology grade inversely correlated with liver stiffness (n = 23; P = 0.01). No correlation was found between histology and imaging (n = 34; P = 0.22; chi-squared). Serum platelet count and enhanced liver fibrosis correlated with imaging (steatosis vs fibrosis/cirrhosis) (n = 85 (P < 0.01) and n = 12 (P = 0.05), respectively; Spearman). AST:ALT and FIB-4 scores correlated with liver stiffness at a threshold of 12 kPa (Spearman correlation coefficient: 0.943 [P < 0.01; n = 6]; Spearman correlation coefficient: 0.417 [P = 0.02; n = 31]; respectively).</p><p><strong>Conclusion: </strong>Variations in the use and performance of noninvasive tools and histological reporting in adult IFALD were found. Prospective studies of noninvasive tools and expert histological consensus on reporting practice are justified.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measures of nutrition intake and growth reported in preterm nutrition studies: A scoping review.","authors":"Meiliana Meiliana, Frank H Bloomfield, Jane E Harding, Luling Lin","doi":"10.1002/jpen.2768","DOIUrl":"https://doi.org/10.1002/jpen.2768","url":null,"abstract":"<p><p>There are inconsistent recommendations in available guidelines and uncertainty regarding the exact nutrient requirements for preterm infants, partly because of inconsistent outcome reporting in nutrition intervention studies. To support development of a minimum reporting set, we undertook a scoping review to identify measures of nutrition intake and growth outcomes reported in recent preterm nutrition studies. We searched for publications from 2018 to 2023 reporting individuals born preterm at any gestational age and study location whose nutrition intake was assessed before first hospital discharge and whose growth was assessed at any age. One reviewer screened articles and extracted the measures. Any uncertainties were resolved by a second reviewer. The results were tabulated and analyzed descriptively. We identified 6365 records, and included 250 studies. Only 10 of 236 studies (4%) reported how nutrition intake was calculated. There were five different ways of reporting weight and 13 of weight gain, each at many different time points. Furthermore, 27 of 105 studies (26%) did not report how weight gain was calculated, and those that did reported five different calculation methods. Our findings demonstrate significant variation and incomplete reporting of nutrition intake and growth outcomes in preterm nutrition studies. This lack of standardization limits the utility of existing evidence and highlights the need for a standardized reporting framework to improve comparability and support evidence-based guidelines in preterm nutrition.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central line-associated bloodstream infection rates in pediatric short bowel syndrome in the United States: A retrospective cohort study from 2016 to 2023.","authors":"Susan A Gutierrez, Vikram Raghu, Stephanie B Oliveira, Vivien Nguyen, Amy M Shui, Debra L Sudan, Conrad Cole, Chiung-Yu Huang, Sue Rhee, Jennifer C Lai, Sharad I Wadhwani","doi":"10.1002/jpen.2766","DOIUrl":"https://doi.org/10.1002/jpen.2766","url":null,"abstract":"<p><strong>Background: </strong>Central line-associated bloodstream infections (CLABSIs) are the leading cause of hospitalization in pediatric short bowel syndrome, disproportionately impacting socioeconomically disadvantaged children. We examined changes in overall CLABSI rates over time and assessed whether socioeconomic disparities persist.</p><p><strong>Methods: </strong>Using the Pediatric Health Information System database, we studied short bowel syndrome patients aged <18 years hospitalized between 2015 and 2023. Patients were stratified into neighborhood income groups based on zip code-based median household income. CLABSI rates were assessed with mixed-effects Poisson regression over four eras (2016-2017, 2018-2019, 2020-2021, 2022-2023).</p><p><strong>Results: </strong>Of 8772 hospitalizations of 2048 children with short bowel syndrome at 43 institutions, CLABSI was the principal diagnosis for 30% of hospitalizations. Univariable analysis showed decreased CLABSI rates during 2018-2019 (rate ratio [RR] 0.71, 95% CI 0.63-0.81; P < 0.001), 2020-2021 (RR 0.66, 95% CI 0.57-0.75; P < 0.001), and 2022-2023 (RR 0.60, 95% CI 0.52-0.70; P < 0.001), relative to 2016-2017. In multivariable analyses, 2022-2023 was associated with lower CLABSI rates relative to 2016-2017 (RR 0.61, 95% CI 0.52-0.70; P < 0.001). Low neighborhood income (RR 1.59, 95% CI 1.14-2.21; P < 0.001), public insurance (RR 1.59, 95% CI 1.37-1.84; P < 0.001), and non-Hispanic Black race (RR 1.19, 95% CI 1.01-1.39; P = 0.03) were associated with higher CLABSI rates relative to high neighborhood income, private insurance, and non-Hispanic White race, respectively.</p><p><strong>Conclusion: </strong>CLABSI rates in pediatric short bowel syndrome have decreased over the past 8 years, yet socioeconomic and racial disparities persist. Efforts to prevent CLABSI across the socioeconomic spectrum should be prioritized to improve short bowel syndrome outcomes.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional adequacy in critically ill adults receiving noninvasive ventilation: A descriptive cohort study.","authors":"Francesca Deli, Kevin Whelan, Danielle E Bear","doi":"10.1002/jpen.2764","DOIUrl":"https://doi.org/10.1002/jpen.2764","url":null,"abstract":"<p><strong>Background: </strong>Noninvasive ventilation (NIV) is increasingly being used in critical care, yet limited evidence exists guiding nutrition practices for patients who are critically ill receiving NIV. This study aimed to describe the nutrition practices and adequacy of nutrition intake among patients who are critically ill receiving NIV.</p><p><strong>Methods: </strong>This descriptive cohort study included adult patients admitted to critical care who received NIV on ≥3 consecutive days. Prospectively recorded clinical data were retrospectively extracted from electronic medical records and compared between patients who received solely noninvasive ventilation (NIV only) and those who received invasive mechanical ventilation (IMV) and were extubated onto noninvasive ventilation (post-IMV group).</p><p><strong>Results: </strong>Of the 220 patients included (107 NIV only; 113 post-IMV), 142 (64.5%) received exclusive oral nutrition, 66 (30.0%) received artificial nutrition support, and 12 (5.5%) received no nutrition. Enteral nutrition was more prevalent in the post-IMV group (36 [31.9%] vs NIV only 19 [17.8%]; P = 0.01), whereas exclusive oral nutrition was more prevalent in the NIV-only group (86 [80.4%] vs post-IMV 66 [58.4%]; P < 0.001). Most patients who received purely exclusive oral nutrition (n = 152) had inadequate intake (94 [61.8%]).</p><p><strong>Conclusion: </strong>Most patients with critically illness receiving NIV received exclusive oral nutrition, which was found to be inadequate in the majority. Patients receiving NIV represent a nutritionally at-risk population, and future studies are needed to understand the barriers to oral intake and the feasibility, safety, and effectiveness of enteral nutrition.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in adverse events associated with different infusion modalities of parenteral nutrition: A pharmacovigilance study.","authors":"Zhou Jing, Jiang Zhengli, Su Ying, Man Shiyu, Ma Jingjing, Pang Mujuan, Xu Hongyan, Hu Yan","doi":"10.1002/jpen.2763","DOIUrl":"https://doi.org/10.1002/jpen.2763","url":null,"abstract":"<p><strong>Background: </strong>Parenteral nutrition can be administered through various infusion modalities. However, limited research has examined the differences in adverse reactions associated with these modalities.</p><p><strong>Methods: </strong>Data from the Food and Drug Administration adverse event reporting system database were analyzed using disproportionality analysis to identify and compare adverse event signals across different infusion modalities.</p><p><strong>Results: </strong>A total of 1642 adverse event reports related to parenteral nutrition were included: 356 in the all-in-one group, 85 in the two-in-one group, 1086 in the fat emulsion group, and 115 in the amino acid supplementation group. Across all reports, 4159 preferred terms were identified, distributed as follows: 858 in the all-in-one group, 152 in the two-in-one group, 2975 in the fat emulsion group, and 174 in the amino acid supplementation group, with these events spanning 20 system organ classes. In the all-in-one group, the top three preferred terms were lymphangitis, increased blood magnesium, and incorrect drug administration rate. In the two-in-one group, the leading preferred terms were fungemia, extravasation, and disease complications. In the fat emulsion group, the most significant preferred terms included fat overload syndrome, fatty acid deficiency, and parenteral nutrition-associated liver disease. In the amino acid supplementation group, key preferred terms were impaired glucose tolerance, hyperglycemia, and elevated hepatic enzymes.</p><p><strong>Conclusion: </strong>This study identified significant variations in the adverse events associated with different parenteral nutrition infusion modalities. These findings underscore the need for tailored interventions to ensure the safe and effective use of parenteral nutrition, thereby optimizing therapeutic outcomes in clinical practice.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence and unknowns for the relevancy of applying current parenteral nutrition support recommendations among infants born less than 750 g or younger than 25 weeks' gestation: A narrative review.","authors":"Mar Romero-Lopez, Mamta Naik, Teresa Hartman, Ann Anderson-Berry, Melissa Thoene","doi":"10.1002/jpen.2761","DOIUrl":"https://doi.org/10.1002/jpen.2761","url":null,"abstract":"<p><p>With advancements in neonatal care, the viability of extremely low-birth-weight (ELBW) infants, especially those born extremely preterm, is increasing. However, specific recommendations for managing parenteral nutrition (PN) support in nanopreterm infants (<750 g or <25 weeks' gestation) are lacking. We aim to evaluate current recommendations and highlight considerations for applying them to nanopreterm infants. The author team used English-language articles related to nutrition in ELBW with emphasis on nanopreterm infants, along with studies on fetal growth and metabolism. Current PN support recommendations for ELBW infants may not suit nanopreterm infants due to physiological and developmental differences. Key considerations for nanopreterm infants include: Carbohydrate: They require immediate dextrose provision with low glucose infusion rates because of limited glycogen stores, immature gluconeogenesis, and impaired glucose intolerance. Lipids: Although essential for energy storage and cell membrane integrity, the ability to metabolize them may be limited, requiring careful consideration of lipid injectable emulsion provision and dosing. Protein: Protein is crucial for growth and development. However, achieving euglycemia is essential for proper amino acid utilization, requiring a delicate balance of dextrose and protein provision. Energy: Because of lower muscle and tissue mass and immature metabolic capabilities, existing recommendations may overestimate their energy needs. Micronutrients: Exact micronutrient requirements are unknown during this specific period of fetal development. This review highlights the limitations of available PN support recommendations for nanopreterm infants. Further research is needed to establish precise guidelines that optimally meet their nutrition needs.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLIM consensus approach to diagnosis of malnutrition: A 5-year update","authors":"Gordon L. Jensen MD, PhD,&nbsp;Tommy Cederholm MD, PhD,&nbsp;M. Isabel T. D. Correia MD, PhD,&nbsp;M. Cristina Gonzalez MD, PhD,&nbsp;Ryoji Fukushima MD, PhD,&nbsp;Veeradej Pisprasert MD, PhD,&nbsp;Renee Blaauw PhD, RD,&nbsp;Diana Cardenas Braz MD, PhD,&nbsp;Fernando Carrasco MD, MS,&nbsp;Alfonso J. Cruz Jentoft MD, PhD,&nbsp;Cristina Cuerda MD, PhD,&nbsp;David C. Evans MD,&nbsp;Vanessa Fuchs-Tarlovsky PhD, MD,&nbsp;Leah Gramlich MD,&nbsp;Han Ping Shi MD, PhD,&nbsp;Jeanette M. Hasse PhD, RD,&nbsp;Michael Hiesmayr MD,&nbsp;Naoki Hiki MD, PhD,&nbsp;Harriët Jager-Wittenaar PhD, RD,&nbsp;Shukri Jahit MD,&nbsp;Anayanet Jáquez MD,&nbsp;Heather Keller PhD, RD,&nbsp;Stanislaw Klek MD, PhD,&nbsp;Ainsley Malone MS, RD,&nbsp;Kris M. Mogensen MS, RD-AP,&nbsp;Naoharu Mori MD, PhD,&nbsp;Manpreet Mundi MD,&nbsp;Maurizio Muscaritoli MD,&nbsp;Doris Ng MRCP, DPhil,&nbsp;Ibolya Nyulasi MSc, APD,&nbsp;Matthias Pirlich MD, PhD,&nbsp;Stephane Schneider MD, PhD,&nbsp;Marian de van der Schueren PhD, RD,&nbsp;Soranit Siltharm MD,&nbsp;Pierre Singer MD,&nbsp;Alison Steiber PhD, RDN,&nbsp;Kelly A. Tappenden PhD, RD,&nbsp;Jianchun Yu MD, PhD,&nbsp;André van Gossum MD, PhD,&nbsp;Jaw-Yuan Wang MD, PhD,&nbsp;Marion F. Winkler PhD, RD,&nbsp;Charlene Compher PhD, RD,&nbsp;Rocco Barazzoni MD, PhD","doi":"10.1002/jpen.2756","DOIUrl":"https://doi.org/10.1002/jpen.2756","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 that comprised screening followed by assessment of three phenotypic criteria (weight loss, low body mass index [BMI], and low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden). This planned update reconsiders the GLIM framework based on published knowledge and experience over the past 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A working group (<i>n</i> = 43 members) conducted a literature search spanning 2019–2024 using the keywords “Global Leadership Initiative on Malnutrition or GLIM.” Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 4","pages":"414-427"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2756","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}